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Aims: The aim of this study is to extend understandings of the impact of surgically diagnosed endometriosis on women's social lives, work and education. Methods: Participants (N = 200; average age: 27.1 years (±6.72)) were recruited from a range of sources, including social media and private women's health clinics. They completed an online survey comprising seven open‐ended questions about how experience with endometriosis impacted (i) overall life; (ii) family relationships; (iii) friendships; (iv) attendance at social events; (v) engagement in leisure activities; (vi) work; and (vii) education. Data were analysed using inductive classical content analysis. Results: The data set contained 1400 discrete codable statements, with 19% of women reporting some form of social impact. A key result was the role of family and friends, both positive and negative, as well as the positive role that the workplace/educational institution can play (noted by 50% of participants). Findings highlight the negative impact on leisure activities, reported by 86% of women. The exhaustion of sick and unpaid leave was reported by 41% of women. Conclusion: This study highlights the impact of endometriosis on the social and economic lives of Australian women and underscores the importance of the comprehensive response recommended in the National Action Plan for Endometriosis. [ABSTRACT FROM AUTHOR]

Objective: Regular screening for colorectal cancer (CRC) can substantially improve outcomes. This study investigated how measuring regret expected from failing to screen might lead to stronger screening intentions. Five potential moderators were evaluated: perceived threat, psychological reactance, prior screening participation, concurrently measuring faecal aversion (FA) and anticipated regret (AR). Design: A 2 (AR measured pre/post intention) × 2 (FA measured pre/post intention) single blind parallel randomised controlled trial was used. Australians aged 45 and over completed an online survey measuring AR, FA, intention, theory of planned behaviour variables and potential moderators. Main outcome measures: The primary outcome was CRC screening intention. Results: Eight hundred and three participants were randomised, with 666 analysed. Measuring AR prior to intention unexpectedly resulted in a significantly lower intention to screen (d = 0.18, 95% CI [0.03, 0.33]) compared to measuring after intention. Trait reactance predicted a significantly lower intention when it was at least 0.52 SD above the mean; other moderators were not supported. Conclusion: The processes underlying anticipated regret manipulations must be better understood in order to have practical value in health promotion. More research is required to determine how to minimise or avoid the apparent negative effects of psychological reactance in CRC screening communication. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12618001098224 [ABSTRACT FROM AUTHOR]

Background Induction of labor, an increasingly common intervention, is often preceded by the application of an agent to 'prime' or 'ripen' the cervix. We conducted a randomized controlled trial to compare clinical, economic, and psychosocial outcomes of inpatient and outpatient cervical priming before induction of labor. In this paper we present the psychosocial outcomes. Methods Women participating in a randomized controlled trial in two Australian metropolitan teaching hospitals completed questionnaires to measure anxiety and depression at enrollment, and to examine satisfaction, experiences, depression, and infant feeding 7 weeks after giving birth. Data analysis was by intention to treat and by having received the intervention as intended (approximately 50% in each group). Results Of 1,004 eligible women, 85 percent consented ( n = 407, outpatient; n = 414 inpatient). No statistically significant or clinically relevant differences were found in immediate anxiety, depression, or infant feeding. Small, statistically significant differences favoring outpatient priming were found in seven of the nine subscales in the 7-week postpartum questionnaire. The direction of the effect was maintained, mostly with a larger effect size in women who received the intervention. Conclusion Women allocated to outpatient priming were more satisfied with their priming experience than women allocated to inpatient priming. Being informed that they could go home after cervical priming did not increase women's anxiety. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast density is an independent risk factor for breast cancer and can impede detection of cancer by mammography. There is growing awareness of breast density in Australia and globally, but it is unclear whether this awareness is increasing knowledge of what breast density is and what it means to have dense breasts. This study was conducted to investigate South Australian women's knowledge of the common facts and misconceptions about breast density. This study reports that women who had previously heard the term breast density had increased knowledge compared to those who had not, suggesting that current efforts to raise awareness are leading to better knowledge. Despite this, the study shows that there are widespread misconceptions that must be actively dispelled, including the misunderstanding that breast density can be determined by touch. Background: There is growing awareness of breast density in women attending breast cancer screening; however, it is unclear whether this awareness is associated with increased knowledge. This study aims to evaluate breast density knowledge among Australian women attending breast cancer screening. Method: This cross-sectional study was conducted on women undergoing breast cancer screening at The Queen Elizabeth Hospital Breast/Endocrine outpatient department. Participants were provided with a questionnaire to assess knowledge, awareness, and desire to know their own breast density. Result: Of the 350 women who participated, 61% were familiar with 'breast density' and 57% had 'some knowledge'. Prior breast density notification (OR = 4.99, 95% CI = 2.76, 9.03; p = 0.004), awareness (OR = 4.05, 95% CI = 2.57, 6.39; p = 0.004), younger age (OR = 0.97, 95% CI = 0.96, 0.99; p = 0.02), and English as the language spoken at home (OR = 3.29, 95% CI = 1.23, 8.77; p = 0.02) were independent predictors of 'some knowledge' of breast density. A significant proportion of participants (82%) expressed desire to ascertain their individual breast density. Conclusions: While knowledge of breast density in this Australian cohort is generally quite low, we have identified factors associated with increased knowledge. Further research is required to determine optimal interventions to increase breast density knowledge. [ABSTRACT FROM AUTHOR]

Objectives: Farmers are faced with many stressors, along with numerous barriers to accessing traditional forms of mental health support. The ifarmwell online intervention was co-designed with farmers and is informed by Acceptance and Commitment Therapy to equip farmers with transferable coping strategies, particularly to help them cope with circumstances beyond their control. We aimed to evaluate the effect of ifarmwell on farmers' short- and long-term distress and mental wellbeing. Methods: Australian farmers (21–73 years) who registered on completed measures at the commencement of module 1 (N = 228), the end of the intervention (N = 77) and 6-months post-intervention (N = 61). Primary outcomes included distress (Kessler Psychological Distress Scale) and mental wellbeing (Mental Health Continuum – Short Form). We also examined the relationship between distress, mental wellbeing, neuroticism (Quickscales-R) and ACT-based psychological mechanisms; psychological inflexibility (Acceptance and Action Questionnaire-II), cognitive fusion (Cognitive Fusion Questionnaire), believability of automatic thoughts (Automatic Thoughts Questionnaire-B), coping via acceptance (4 items from the situational COPE) and mindfulness (Five Facet Mindfulness Questionnaire-Short Form). Secondary outcomes of acceptability (Client Satisfaction Questionnaire-8) and usability (System Usability Scale) were also explored. Results: Pre- to post-intervention, farmers' distress decreased and mental wellbeing increased. These effects were maintained at 6-month follow-up. Changes in these outcomes were greatest for participants who entered the intervention with high baseline distress ( β ˆ = −0.59, 95%CI =[−0.70, −0.47]) and low mental wellbeing ( β ˆ = −0.33, 95%CI = [−0.47, −0.19]). Decreases in distress and increases in mental wellbeing were associated with decreases in psychological inflexibility, cognitive fusion, and believability of thoughts, and increases in coping via acceptance and mindfulness. Levels of satisfaction (M = 26.92/32) and usability (M = 84.70/100) were high, and 94.6% of participants said they would recommend ifarmwell to a friend in need of similar advice and tools. Conclusions: ifarmwell is an effective and usable intervention that is likely to help farmers reduce their levels of distress and improve their mental wellbeing, by improving their psychological flexibility, ability to focus on the present and accept things beyond their control, as well as by reducing the extent to which they believe unhelpful thoughts. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted by Jodie M. Dodd and colleagues for the LIMIT Randomised Trial Group which aims to know whether antenatal lifestyle advice offered to overweight or obese pregnant women can improve the health outcomes of mother and child. Included in the article are the primary outcome, main results and the role of chance, and the summary result of the study. It offers information on the methodology of the study including design, and participants and setting.

This research aimed to develop an evidence-based and community-defined model for multiple stakeholders such as community leaders, service providers, and policymakers to adaptively implement to improve the quality of life of these children and their families. To inform this model, results from three previous studies conducted by the authors were combined with the results from the current qualitative investigation. Overall over 100 key informants including parents, community leaders, and government and non-government officials aged from 18 to 63 years old participated in interview and focus group sessions. The results were then analysed thematically. The resultant model consists of 41 activities across 7 sectors, including health, education, and the economy, plus a central multi-sectoral component. Taken together, this comprehensive list of activities aims to support young children's development, increase family competencies, and strengthen social inclusion for families with children with disabilities. Young children with disabilities are among the most vulnerable population in the world. A range of evidence-informed activities exists to help young children with disabilities in low and middle-income countries with settings similar to that in Indonesia. We united these activities together with additional suggestions through a series of investigations to generate an evidence-informed and community-defined model for improving the quality of life of these children and their families. We hope that this article assists researchers and practitioners to adaptively implement such approaches to improve the lives of young children with disabilities. [ABSTRACT FROM AUTHOR]

Objective Australian Aboriginal and Torres Strait Islander people suffer health inequities, such as high levels of psychological distress and multiple life stressors. These have been shaped by colonisation, racism, discrimination, and government policies and practices. Method Eight Australian psychologists were interviewed with the aim of identifying the professional skills and personal competencies that enable effective service delivery for this client group, and especially those aged 12-25 (i.e., 'youth'). Results Thematic analysis identified that personal and clinical credibility, relationship centrism, contextual understanding, a holistic approach, and flexibility are important to good practice. Not all of these are currently part of standard psychology training, but many are covered by guidelines developed by the Australian Psychological Society. Conclusions Results from this study indicate that ongoing adjustments to university curricula, professional competency requirements for practitioner registration, and continuing professional development will all contribute to best practice. Moreover, for Australian psychologists, the consolidation of cultural competency into a useful framework for professional development is paramount. [ABSTRACT FROM AUTHOR]

Bullying is a widespread global issue, with serious consequences for victimized individuals. The current systematic review is the first to explore the consequences of bullying in early adolescence on psychological and academic functioning across the adolescent period. Five databases were examined, yielding 28 relevant studies. Victimized individuals were found to experience negative psychosocial and academic outcomes, including increased depression and anxiety, increased peer rejection, poorer school performance and school connectedness, both over the short term (12 months), and up to 8 years later. Victimized females suffered worse outcomes than victimized males, specifically for symptoms of depression, anxiety and suicidal ideation. Future research should prioritize developing a globally recognized measure of bullying, and designing targeted interventions addressing specific outcomes for victimized females and males. [ABSTRACT FROM AUTHOR]

Primary health care (PHC) plays a vital support role in organised colorectal cancer (CRC) screening programs by encouraging patient participation and ensuring timely referral for diagnostic assessment follow up. A systematic scoping review of the current evidence was conducted to inform strategies that better engage the PHC sector in organised CRC screening programs. Articles published from 2005 to November 2019 were searched across five databases. Evidence was synthesised and interventions that specifically require PHC involvement were mapped to stages of the CRC screening pathway. Fifty-seven unique studies were identified in which patient, provider and system-level interventions align with defined stages of the CRC screening pathway: namely, identifying/reminding patients who have not responded to CRC screening (non-adherence) (n = 46) and follow up of a positive screen referral (n = 11). Self-management support initiatives (patient level) and improvement initiatives (system level) demonstrate consistent benefits along the CRC screening pathway. Interventions evaluated as part of a quality-improvement process tended to report effectiveness; however, the variation in reporting makes it difficult to determine which elements contributed to the overall study outcomes. To maximise the benefits of population-based screening programs, better integration into existing primary care services can be achieved through targeting preventive and quality care interventions along the entire screening pathway. [ABSTRACT FROM AUTHOR]

Background: The continuum of resistance model contends that respondents lie at one end of a continuum and non-respondents at the other with respect to factors demonstrated to impact on screening participation. Purpose: The aim of this study was to explore the validity of this model for the prediction of participation in colorectal cancer screening. Method: People aged 50 to 74 years were asked to complete a survey ( n = 1,250). Eligible respondents ( n = 376, 30 %) were invited to complete a faecal occult blood test (FOBT). The cutoff period for the determination of participation rates was 12 weeks, with a reminder sent at 6 weeks. Results: FOBTs were returned by n = 196 people (132 within 6 weeks, 64 following a reminder). Participation was generally influenced by the same variables in both the first 6 weeks and the second 6 weeks, consistent with the continuum of resistance model. These variables were having known someonewith bowelcancer and the social cognitive factor, perceptions ofbarriers toscreening. There is a suggestion, however, that other factors may be differentially associated with early, late and non-participants. Conclusion: Participation in screening appears somewhat consistent with the continuum of resistance model in that early and late participants respond to some of the same factors. This suggests that the same messages are relevant to early, late and non-screeners, but further consideration of what other factors may be influencing discrete stages of readiness to participate is necessary. [ABSTRACT FROM AUTHOR]

Objective To compare the costs of inpatient (usual care) with outpatient (intervention) care for cervical priming for induction of labour in women with healthy, low-risk pregnancies who are being induced for prolonged pregnancies or for social reasons. Methods Data from a randomised controlled trial at two hospitals in South Australia were matched with hospital financial data. A cost analysis comparing women randomised to inpatient care with those randomised to outpatient care was performed, with an additional analysis focusing on those who received the intervention. Results Overall, 48% of women randomised into the trial did not receive the intervention. Women randomised to outpatient care had an overall cost saving of $319 per woman (95% CI -$104 to $742) as compared with women randomised to usual care. When restricted to women who actually received the intervention, in-hospital cost savings of $433 (95% CI -$282 to $1148) were demonstrated in the outpatient group. However, these savings were partially offset by the cost of an outpatient priming clinic, reducing the overall cost savings to $156 per woman. Conclusions Overall cost savings were not statistically significant in women who were randomised to or received the intervention. However, the trend in cost savings favoured outpatient priming. What is known about the topic? Induction of labour is a common obstetric intervention. For women with low-risk, prolonged pregnancies who require cervical priming there has been increased interest in whether this period of waiting for the cervix to 'ripen' can be achieved at home. Outpatient priming has been reported to reduce hospital costs and improve maternal satisfaction. However, few studies have actually examined the cost of outpatient priming for induction of labour. What does this paper add? This is the first paper in Australia to both assess the full cost of outpatient cervical priming and to compare it with usual (inpatient) care. This is the first costing paper from a randomised controlled trial directly comparing inpatient and outpatient priming with prostaglandin E[sub 2]. What are the implications for practitioners? For women with prolonged, low-risk pregnancies, a program of outpatient cervical priming can potentially reduce in-hospital costs and free up labour ward beds by avoiding an additional overnight hospitalisation. [ABSTRACT FROM AUTHOR]

Aim and objective. This study aimed to understand older people's perceptions of their and other older peoples' falls risk, to increase understanding of why older people might not believe falls are relevant to themselves. Background. One-third of the people aged ≥65 years (older people) fall yearly. Many older people do not participate in falls prevention programmes because they purport they are not personally vulnerable. Design. A qualitative study was conducted, guided by the tenets of grounded theory. Method. Semi-structured interviews were conducted with nine community-dwelling older people living in metropolitan Adelaide, South Australia. The interview explored participant's direct and indirect experience of falling, their perceived chance of falling in the next 12 months and that of others of the same age and sex to themselves and their reasons for this. Results. Participants carefully presented themselves as being 'not the type who fall', who they view negatively. They believed their or their friends past or future falls were (or could be) because of factors outside of their personal control or because they were not paying attention at that moment of falling, as opposed to being the type of person who falls. They used these explanations as strategies to maintain or protect their identity as being physically competent. Conclusions. Older people know that falling can be viewed negatively. Falling is a threat to their identity as the type of person who does not fall. This explanation is consistent with self-presentation theory, where people use accounting strategies in social interaction to create a desired impression. Relevance to clinical practice. Falls prevention messages are likely to be rejected if the target group associate the message with a negative identity. These findings can assist nurses to understand older people's reluctance to engage in falls prevention and can stimulate thinking regarding alternative engagement strategies. [ABSTRACT FROM AUTHOR]